Individual
DR. BUDIARTO RANOEWIDJOJO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
506 LENOX AVE, NEW YORK, NY 10037-1802
(212) 939-2251
Mailing address
134 HAVEN AVE APT 3B, NEW YORK, NY 10032-1126
(909) 319-5342
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
253948
NY
Other
Enumeration date
07/24/2009
Last updated
07/24/2009
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